Key Takeaways & Executive Findings
- •• Cervical instability in middle-aged and young adults is associated with reduced relative cross-sectional area and increased fat infiltration in deep posterior cervical muscles. • C4/5 angular displacement negatively correlates with the relative cross-sectional area of deep posterior cervical muscles, indicating a potential biomechanical link. • Patients with cervical instability exhibit greater C4/5 horizontal and angular displacements, and smaller cervical curvature compared to healthy controls. • Deep posterior cervical muscle changes may serve as early indicators for prevention and intervention of cervical instability in this population.
Abstract
BACKGROUND: The onset of cervical instability in middle-aged and young adults often begins with neck muscle injuries. A deeper understanding of changes in neck muscles during cervical instability and their correlation can provide valuable data to support the prevention and treatment of cervical instability in this population. OBJECTIVE: To explore the correlation between cervical instability and neck muscle changes in middle-aged and young adults. METHODS: A total of 98 patients with cervical C4/5 instability and 88 healthy subjects, aged 18-45 years, were enrolled through recruitment advertisements and the Department of Spine, Wangjing Hospital, China Academy of Traditional Chinese Medicine. Cervical X-rays were collected to measure cervical curvature and C4/5 vertebral angular displacement. Cervical magnetic resonance imaging was taken to obtain data on C4/5 intervertebral disc signal intensity, as well as the relative cross-sectional area and fat ratio of neck muscles, including prevertebral muscles, deep posterior cervical muscles, and superficial muscles. A univariate intergroup comparison of X-ray and magnetic resonance imaging data was conducted between cervical instability subjects and healthy controls, along with Spearman correlation analysis between C4/5 angular displacement and disc signal intensity, relative cross-sectional area of neck muscles and fat percentage at the C4/5 level in cervical instability patients. RESULTS AND CONCLUSION: The cervical instability group had significantly greater age, C4/5 horizontal displacement, C4/5 angular displacement, and fat ratio of deep posterior cervical muscles than the healthy group (P < 0.05), while cervical curvature and relative cross-sectional area of deep posterior cervical muscles were significantly smaller (P < 0.05). Spearman correlation analysis showed a negative correlation between C4/5 angular displacement and relative cross-sectional area of deep posterior cervical muscles (P < 0.05). These findings suggest that changes in deep posterior cervical muscles may be closely related to the occurrence of cervical instability in middle-aged and young adults.
1. Introduction
Cervical instability is a condition caused by degeneration of cervical structure and function, leading to excessive or abnormal movement of vertebral segments under physiological conditions, and resulting in a series of clinical symptoms such as neck and shoulder pain, headache, and dizziness [1]. It is considered an early pathological stage of cervical spondylosis [2], and if left untreated, may progress to irreversible lesions such as osteophyte formation and intervertebral disc herniation [3-4]. With the rapid development of informatization and increasing use of electronic devices in China, the incidence of cervical instability among middle-aged and young adults has been rising [5], and recurrent discomfort seriously affects patients' quality of life. Therefore, correctly understanding and paying attention to cervical instability in this population, along with early prevention and precise intervention, is of great significance for reducing the incidence of cervical spondylosis.
Neck muscles are important structures for maintaining cervical stability and coordinating cervical motion [6]. Most scholars believe that the onset of cervical instability in middle-aged and young adults often begins with neck muscle injuries [7-8]. Thus, a deeper understanding of neck muscle changes during cervical instability can provide valuable data to support clinical prevention and treatment. Cervical X-ray and MRI, as commonly used imaging modalities in clinical and research settings, can clearly reveal the characteristics of cervical bony and soft tissue structures, respectively, making them powerful tools for research on cervical instability [3,9]. Based on this background, the present study selected middle-aged and young patients with cervical instability as subjects and investigated the correlation between cervical instability and neck muscle changes using cervical X-ray and MRI imaging.
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Lu Guangqi, Li Jing, Sun Xinyue, Liang Long, Liu Guangwei, Zhou Shuaiqi, Mao Hanze, Ma Mingming, Cui Ying, Liu Yakun, Hu Jiaming, Zhu Liguo, Yu Jie, Zhuang Minghui (2026). Correlation between cervical instability and neck muscle changes in middle-aged and young adults. Chinese Journal of Tissue Engineering Research. https://doi.org/10.12307/2026.21287
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Frequently Asked Questions
What is cervical instability?
Cervical instability is a condition where the cervical spine loses its normal stability, leading to excessive or abnormal movement of vertebral segments. It can cause symptoms such as neck pain, headache, and dizziness, and is considered an early stage of cervical spondylosis.
How does cervical instability relate to neck muscle changes?
The study found that in middle-aged and young adults with cervical instability, the deep posterior cervical muscles show a reduced relative cross-sectional area and increased fat infiltration, suggesting that muscle changes may contribute to or result from instability.
What imaging methods were used in the study?
The study used cervical X-rays to measure cervical curvature and C4/5 vertebral angular displacement, and cervical MRI to assess intervertebral disc signal intensity, as well as the relative cross-sectional area and fat ratio of neck muscles.
Who were the participants in the study?
The study included 98 patients with cervical C4/5 instability and 88 healthy subjects, all aged 18-45 years, recruited from Wangjing Hospital, China Academy of Traditional Chinese Medicine.
What are the key findings of the study?
The key findings are that patients with cervical instability have greater C4/5 displacements, smaller cervical curvature, and altered deep posterior cervical muscles (reduced area and increased fat) compared to healthy controls. Additionally, C4/5 angular displacement negatively correlates with the relative cross-sectional area of deep posterior cervical muscles.
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